Asthma is the most common serious chronic illness in children in the U.S. An estimated 6.8 million children under 18, 1.2 million of them under age 5, had asthma in 2006. It is the third-leading cause of hospitalization in children under 15 years of age. Asthma cannot be cured, but in most cases it can be controlled. The American Lung Association has made childhood asthma a priority. Recent studies have indicated that vitamin D deficiency in children and in pregnant women may increase the risk of asthma in children. Vitamin D is synthesized in humans by the skin when it is exposed to sunlight. It is also found in a variety of food sources such as fish, eggs, fortified milk, and cod liver oil. Vitamin D deficiency is prevented by as little as 10 minutes of sunshine per day. Vitamin D plays a major role in maintaining calcium and phosphorous levels. Calcium is very important for healthy bones and muscle function.

Researchers have proposed a variety of reasons for vitamin D deficiency in women and children. It is believed most people derive very little vitamin D from their diet and that reduced sunlight is the primary contributor to deficiency. One theory is that children with severe asthma may spend more time indoors to avoid asthma triggers, thereby reducing exposure to sunlight. Another is that as standard of living increases people of all ages spend less time outdoors as they drive in cars rather than walk or bike and they spend more time watching television, on the computer or playing video games. There is too little information available now to recommend vitamin D supplementation but it is felt that studies should be conducted to measure the effects of supplementation in pregnant women and children on childhood asthma.

Another theorized contributing factor to current childhood asthma levels is the use of acetaminophen (Tylenol and others) to treat pain and fever in children. Frequent acetaminophen use in children under 1 year of age has been associated with an increased risk of asthma in 6- and 7-year-olds. One hypothesis is that acetaminophen depletes glutathione. Glutathione is produced by the body and acts as an antioxidant within cells. It is theorized that decreased glutathione levels in lung tissue may increase oxidative stress, contributing to increased asthma symptoms. Acetaminophen use has increased in children because aspirin is associated with Reye's syndrome, a potentially fatal disease that causes damage to all body organs, especially the liver and brain, when used in viral infections in children. Recommendations are now to continue to use acetaminophen in children but to use it only to treat fever over 101 degrees F. Lung function effects do appear to be related to the frequency of use, less frequent use is safer.

My interpretation of this information is that pregnant women and children should be encouraged to spend at least 10 minutes per day outdoors in the sunshine, taking care to avoid sunburn by limiting actual time in the sun to a few minutes at a time and avoiding peak sun intensity. Also parents should limit acetaminophen to infrequent use for treatment of fever over 101 degrees F, especially in children under 1 year old.

References: http://www.lungusa.org/site/c.dvLUK9O0E/b.22691/k.A12D/Asthma__Children.htm, http://www.medpagetoday.com/Pulmonary/Asthma/13877, http://www.mayoclinic.com/health/vitamin-d/NS_patient-vitamind, http://www.webmd.com/asthma/news/20080918/baby_acetaminophen_tied_to_asthma.

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